Significant variations and inconsistency in both the physician's and n
urse's approach to the treatment of neonates with a ''rule-out sepsis'
' (R/O sepsis) diagnosis is seen as both high cost and low quality. Be
cause R/O sepsis is seen as a diagnostic dilemma for practicing clinic
ians, there has been a widespread tendency to readily initiate antibio
tic treatment, without adequate consideration of the high financial an
d morbidity costs associated with the complications of treating the no
ninfected infant. This study demonstrates that the use of an agreed up
on risk profile facilitated the collaborative standardization of diagn
osis and treatment of the R/O sepsis patient, improved quality, and re
duced costs (by minimizing over treatment) without increasing risk. Th
is collaborative approach enhanced nurse-physician relationships, resu
lting in significant cost savings as well as diminished anxiety and co
nfusion among the parents of neonates diagnosed with R/O sepsis.